Pub Date : 2023-08-01Epub Date: 2023-06-10DOI: 10.1007/s11904-023-00663-z
Marta I Mulawa, Elizabeth T Knippler, Maryam Al-Mujtaba, T Harper Wilkinson, Venkata K Ravi, Leila S Ledbetter
Purpose of review: This review of recent studies evaluating interventions to improve HIV care outcomes among adolescents with HIV (AHIV) was conducted to provide a comprehensive overview of the recent evidence, highlight promising approaches, and suggest directions for future research.
Recent findings: Our scoping review revealed 65 studies evaluating a variety of interventions and using a range of study designs at various stages of research. Effective approaches included community-based, integrated service delivery models with case management, trained community adolescent treatment supporters, and consideration of social determinants of health. Recent evidence also supports the feasibility, acceptability, and preliminary efficacy of other innovative approaches, including mental health interventions as well as technology-delivered approaches; however, more research is needed to build the evidence base for these interventions. Our review's findings suggest that interventions providing comprehensive, individualized support are essential to improving HIV care outcomes among adolescents. More research is needed to build the evidence base for such interventions and ensure effective, equitable implementation to support the global target of ending the AIDS epidemic by 2030.
{"title":"Interventions to Improve Adolescent HIV Care Outcomes.","authors":"Marta I Mulawa, Elizabeth T Knippler, Maryam Al-Mujtaba, T Harper Wilkinson, Venkata K Ravi, Leila S Ledbetter","doi":"10.1007/s11904-023-00663-z","DOIUrl":"10.1007/s11904-023-00663-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review of recent studies evaluating interventions to improve HIV care outcomes among adolescents with HIV (AHIV) was conducted to provide a comprehensive overview of the recent evidence, highlight promising approaches, and suggest directions for future research.</p><p><strong>Recent findings: </strong>Our scoping review revealed 65 studies evaluating a variety of interventions and using a range of study designs at various stages of research. Effective approaches included community-based, integrated service delivery models with case management, trained community adolescent treatment supporters, and consideration of social determinants of health. Recent evidence also supports the feasibility, acceptability, and preliminary efficacy of other innovative approaches, including mental health interventions as well as technology-delivered approaches; however, more research is needed to build the evidence base for these interventions. Our review's findings suggest that interventions providing comprehensive, individualized support are essential to improving HIV care outcomes among adolescents. More research is needed to build the evidence base for such interventions and ensure effective, equitable implementation to support the global target of ending the AIDS epidemic by 2030.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 4","pages":"218-230"},"PeriodicalIF":3.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10528099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01Epub Date: 2023-06-21DOI: 10.1007/s11904-023-00662-0
Smritee Dabee, Christina Balle, Maricianah Onono, Steve Innes, Gonasagrie Nair, Thesla Palanee-Phillips, Adam D Burgener, Steven E Bosinger, Jo-Ann S Passmore, Renee Heffron, Heather Jaspan, Anna-Ursula Happel
Purpose of review: The long-acting reversible intramuscularly-injected contraceptive depot medroxyprogesterone acetate (DMPA-IM) is widely used by cisgender women in Africa. Although DMPA-IM provides reliable contraception, potential effects on the female genital tract (FGT) mucosa have raised concern, including risk of HIV infection. This review summarises and compares evidence from observational cohort studies and the randomised Evidence for Contraceptive Options in HIV Outcomes (ECHO) Trial.
Recent findings: Although previous observational studies found women using DMPA-IM had higher abundance of bacterial vaginosis (BV)-associated bacteria, increased inflammation, increased cervicovaginal HIV target cell density, and epithelial barrier damage, sub-studies of the ECHO Trial found no adverse changes in vaginal microbiome, inflammation, proteome, transcriptome, and risk of viral and bacterial STIs, other than an increase in Th17-like cells. Randomised data suggest that DMPA-IM use does not adversely change mucosal endpoints associated with acquisition of infections. These findings support the safe use of DMPA-IM in women at high risk of acquiring STIs, including HIV.
审查目的:醋酸甲羟孕酮长效可逆肌肉注射避孕药(DMPA-IM)被非洲的顺性别妇女广泛使用。虽然 DMPA-IM 能提供可靠的避孕效果,但它对女性生殖道(FGT)粘膜的潜在影响,包括感染 HIV 的风险,引起了人们的关注。本综述总结并比较了观察性队列研究和随机 "艾滋病结果中的避孕选择证据(ECHO)试验 "的证据:尽管之前的观察性研究发现,使用 DMPA-IM 的妇女体内与细菌性阴道病(BV)相关的细菌数量较多、炎症加剧、宫颈阴道 HIV 靶细胞密度增加以及上皮屏障受损,但 ECHO 试验的子研究发现,除了 Th17 样细胞增加外,阴道微生物组、炎症、蛋白质组、转录组以及病毒性和细菌性 STI 风险均未发生不利变化。随机数据表明,使用 DMPA-IM 不会对与感染相关的粘膜终点产生不利影响。这些研究结果支持在感染性传播疾病(包括艾滋病毒)的高风险妇女中安全使用 DMPA-IM。
{"title":"Update on the Impact of Depot Medroxyprogesterone Acetate on Vaginal Mucosal Endpoints and Relevance to Sexually Transmitted Infections.","authors":"Smritee Dabee, Christina Balle, Maricianah Onono, Steve Innes, Gonasagrie Nair, Thesla Palanee-Phillips, Adam D Burgener, Steven E Bosinger, Jo-Ann S Passmore, Renee Heffron, Heather Jaspan, Anna-Ursula Happel","doi":"10.1007/s11904-023-00662-0","DOIUrl":"10.1007/s11904-023-00662-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>The long-acting reversible intramuscularly-injected contraceptive depot medroxyprogesterone acetate (DMPA-IM) is widely used by cisgender women in Africa. Although DMPA-IM provides reliable contraception, potential effects on the female genital tract (FGT) mucosa have raised concern, including risk of HIV infection. This review summarises and compares evidence from observational cohort studies and the randomised Evidence for Contraceptive Options in HIV Outcomes (ECHO) Trial.</p><p><strong>Recent findings: </strong>Although previous observational studies found women using DMPA-IM had higher abundance of bacterial vaginosis (BV)-associated bacteria, increased inflammation, increased cervicovaginal HIV target cell density, and epithelial barrier damage, sub-studies of the ECHO Trial found no adverse changes in vaginal microbiome, inflammation, proteome, transcriptome, and risk of viral and bacterial STIs, other than an increase in Th17-like cells. Randomised data suggest that DMPA-IM use does not adversely change mucosal endpoints associated with acquisition of infections. These findings support the safe use of DMPA-IM in women at high risk of acquiring STIs, including HIV.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 4","pages":"251-260"},"PeriodicalIF":3.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose of review: Sexual and gender minority (SGM) individuals are diagnosed with HIV at disproportionate rates, and hazardous alcohol use can increase their HIV risk. This review assessed the state of the literature examining interventions for addressing alcohol use and sexual HIV risk behaviors among SGM individuals.
Recent findings: Fourteen manuscripts from 2012 to 2022 tested interventions that address both alcohol use and HIV risk behaviors among SGM populations, with only 7 randomized controlled trials (RCTs). Virtually all the interventions targeted men who have sex with men, with none focused on transgender populations or cisgender women. While they demonstrated some evidence of effectiveness in reducing alcohol use and/or sexual risk, the outcomes varied widely between studies. More research is needed that tests interventions in this area, particularly for transgender individuals. The use of larger-scale RCTs with diverse populations and standardized outcome measures are needed to strengthen the evidence base.
审查目的:性与性别少数群体(SGM)被诊断出感染 HIV 的比例过高,而酗酒会增加他们感染 HIV 的风险。本综述评估了针对 SGM 人饮酒和 HIV 性风险行为的干预措施的文献现状:从 2012 年到 2022 年,共有 14 篇手稿测试了针对 SGM 群体中饮酒和 HIV 风险行为的干预措施,其中只有 7 项随机对照试验 (RCT)。几乎所有干预措施都针对男男性行为者,没有一项针对变性人群或顺性女性。虽然这些干预措施在减少饮酒和/或性风险方面显示出一定的有效性,但不同研究的结果差异很大。我们需要更多的研究来检验这一领域的干预措施,尤其是针对变性人的干预措施。需要对不同人群进行更大规模的 RCT 研究,并采用标准化的结果测量方法,以加强证据基础。
{"title":"Interventions to Reduce Alcohol Use and HIV Risk among Sexual and Gender Minority Populations: a Systematic Review.","authors":"Carolyn Lauckner, Kimberly Haney, Fidelis Sesenu, Trace Kershaw","doi":"10.1007/s11904-023-00660-2","DOIUrl":"10.1007/s11904-023-00660-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Sexual and gender minority (SGM) individuals are diagnosed with HIV at disproportionate rates, and hazardous alcohol use can increase their HIV risk. This review assessed the state of the literature examining interventions for addressing alcohol use and sexual HIV risk behaviors among SGM individuals.</p><p><strong>Recent findings: </strong>Fourteen manuscripts from 2012 to 2022 tested interventions that address both alcohol use and HIV risk behaviors among SGM populations, with only 7 randomized controlled trials (RCTs). Virtually all the interventions targeted men who have sex with men, with none focused on transgender populations or cisgender women. While they demonstrated some evidence of effectiveness in reducing alcohol use and/or sexual risk, the outcomes varied widely between studies. More research is needed that tests interventions in this area, particularly for transgender individuals. The use of larger-scale RCTs with diverse populations and standardized outcome measures are needed to strengthen the evidence base.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 4","pages":"231-250"},"PeriodicalIF":4.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10436179/pdf/nihms-1922187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10400317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1007/s11904-023-00654-0
Lidia Flores, Sean D Young
Purpose of review: People who use illicit drug substances (e.g., heroin) and sex workers are vulnerable to acquiring HIV. Due to the criminalization of illicit drug substances and sex work in many countries, these populations often reside in rights-constrained settings where their well-being, freedom, and access to HIV prevention and care services may be compromised due to legal prosecutions and societal stigma.
Recent findings: This study conducted a literature review on papers that evaluated a combination of the following three components: ethics, technology-based research, and populations who use drug substances and/or sex workers. We explored research on these ethical perspectives from both key populations and researchers. Findings revealed potential risks in data security and possible harmful implications of compromised data within these rights-constrained settings. Best practices were explored within the literature to identify potential methods for addressing these ethical concerns and improving HIV prevention and care.
{"title":"Ethical Perspectives in Using Technology-Enabled Research for Key HIV Populations in Rights-Constrained Settings.","authors":"Lidia Flores, Sean D Young","doi":"10.1007/s11904-023-00654-0","DOIUrl":"https://doi.org/10.1007/s11904-023-00654-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>People who use illicit drug substances (e.g., heroin) and sex workers are vulnerable to acquiring HIV. Due to the criminalization of illicit drug substances and sex work in many countries, these populations often reside in rights-constrained settings where their well-being, freedom, and access to HIV prevention and care services may be compromised due to legal prosecutions and societal stigma.</p><p><strong>Recent findings: </strong>This study conducted a literature review on papers that evaluated a combination of the following three components: ethics, technology-based research, and populations who use drug substances and/or sex workers. We explored research on these ethical perspectives from both key populations and researchers. Findings revealed potential risks in data security and possible harmful implications of compromised data within these rights-constrained settings. Best practices were explored within the literature to identify potential methods for addressing these ethical concerns and improving HIV prevention and care.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"148-159"},"PeriodicalIF":4.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1007/s11904-023-00655-z
Lanbo Yang, Mary Catherine Cambou, Karin Nielsen-Saines
Purpose of review: The goal of this review is to highlight and interpret recent trends and developments in the diagnosis, treatment, and prevention of HIV vertical transmission from a clinical perspective.
Recent findings: Universal third-trimester retesting and partner testing may better identify incident HIV among pregnant patients and result in early initiation of antiretroviral therapy to prevent vertical transmission. The proven safety and efficacy of integrase inhibitors such as dolutegravir may be particularly useful in suppressing viremia in pregnant persons who present late for ART treatment. Pre-exposure prophylaxis (PrEP) during pregnancy may play a role in preventing HIV acquisition; however, its role in preventing vertical transmission is difficult to elucidate. Substantial progress has been made in recent years to eliminate HIV perinatal transmission. Future research hinges upon a multipronged approach to improving HIV detection, risk-stratified treatment strategies, and prevention of primary HIV infection among pregnant persons.
{"title":"The End Is in Sight: Current Strategies for the Elimination of HIV Vertical Transmission.","authors":"Lanbo Yang, Mary Catherine Cambou, Karin Nielsen-Saines","doi":"10.1007/s11904-023-00655-z","DOIUrl":"https://doi.org/10.1007/s11904-023-00655-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>The goal of this review is to highlight and interpret recent trends and developments in the diagnosis, treatment, and prevention of HIV vertical transmission from a clinical perspective.</p><p><strong>Recent findings: </strong>Universal third-trimester retesting and partner testing may better identify incident HIV among pregnant patients and result in early initiation of antiretroviral therapy to prevent vertical transmission. The proven safety and efficacy of integrase inhibitors such as dolutegravir may be particularly useful in suppressing viremia in pregnant persons who present late for ART treatment. Pre-exposure prophylaxis (PrEP) during pregnancy may play a role in preventing HIV acquisition; however, its role in preventing vertical transmission is difficult to elucidate. Substantial progress has been made in recent years to eliminate HIV perinatal transmission. Future research hinges upon a multipronged approach to improving HIV detection, risk-stratified treatment strategies, and prevention of primary HIV infection among pregnant persons.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"121-130"},"PeriodicalIF":4.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10239317/pdf/nihms-1888021.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01Epub Date: 2023-05-02DOI: 10.1007/s11904-023-00657-x
Maria J Duarte, Phyllis C Tien, Ma Somsouk, Jennifer C Price
Purpose of review: Chronic liver disease is a major cause of morbidity and mortality amongst people living with HIV (PLWH). Emerging data suggests that gut microbial translocation may play a role in driving and modulating liver disease, a bi-directional relationship termed the gut-liver axis. While it is recognized that PLWH have a high degree of dysbiosis and gut microbial translocation, little is known about the gut-liver axis in PLWH.
Recent findings: Recent studies have shown that microbial translocation can directly lead to hepatic inflammation, and have linked gut microbial signatures, dysbiosis, and translocation to liver disease in PLWH. Additionally, multiple trials have explored interventions targeting the microbiome in PLWH. Emerging research supports the interaction between the gut microbiome and liver disease in PLWH. This offers new opportunities to expand our understanding of the pathophysiology of liver disease in this population, as well as to explore possible clinical interventions.
{"title":"The human microbiome and gut-liver axis in people living with HIV.","authors":"Maria J Duarte, Phyllis C Tien, Ma Somsouk, Jennifer C Price","doi":"10.1007/s11904-023-00657-x","DOIUrl":"10.1007/s11904-023-00657-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic liver disease is a major cause of morbidity and mortality amongst people living with HIV (PLWH). Emerging data suggests that gut microbial translocation may play a role in driving and modulating liver disease, a bi-directional relationship termed the gut-liver axis. While it is recognized that PLWH have a high degree of dysbiosis and gut microbial translocation, little is known about the gut-liver axis in PLWH.</p><p><strong>Recent findings: </strong>Recent studies have shown that microbial translocation can directly lead to hepatic inflammation, and have linked gut microbial signatures, dysbiosis, and translocation to liver disease in PLWH. Additionally, multiple trials have explored interventions targeting the microbiome in PLWH. Emerging research supports the interaction between the gut microbiome and liver disease in PLWH. This offers new opportunities to expand our understanding of the pathophysiology of liver disease in this population, as well as to explore possible clinical interventions.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"170-180"},"PeriodicalIF":3.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10232565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10027495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1007/s11904-023-00658-w
Enbal Shacham, Stephen E Scroggins, Matthew Ellis
Purpose of review: Tremendous advancements have been made in HIV treatment and prevention during the last 40 years that zero new HIV cases has become an attainable goal declared by international agencies. However, new cases of HIV infection persist.
Recent findings: The emerging field of geospatial science is positioned to play key role in the reduction of continued HIV incidence through technology-driven interventions and innovative research that gives insights into at-risk populations. As these methods become more utilized, findings consistently show the important role of location and environment plays in HIV incidence and treatment adherence. This includes distance to HIV provider, locations of where HIV transmissions occurs compared to where people with HIV reside, and how geospatial technology has been leveraged to identify unique insights among varying groups of those at increased risk for HIV, among others. Given these insights, leveraging geospatial technology would play a prominent role in achieving zero new cases of HIV infections.
{"title":"Implementing Geospatial Science and Technology to Get to Zero New HIV Infections.","authors":"Enbal Shacham, Stephen E Scroggins, Matthew Ellis","doi":"10.1007/s11904-023-00658-w","DOIUrl":"https://doi.org/10.1007/s11904-023-00658-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tremendous advancements have been made in HIV treatment and prevention during the last 40 years that zero new HIV cases has become an attainable goal declared by international agencies. However, new cases of HIV infection persist.</p><p><strong>Recent findings: </strong>The emerging field of geospatial science is positioned to play key role in the reduction of continued HIV incidence through technology-driven interventions and innovative research that gives insights into at-risk populations. As these methods become more utilized, findings consistently show the important role of location and environment plays in HIV incidence and treatment adherence. This includes distance to HIV provider, locations of where HIV transmissions occurs compared to where people with HIV reside, and how geospatial technology has been leveraged to identify unique insights among varying groups of those at increased risk for HIV, among others. Given these insights, leveraging geospatial technology would play a prominent role in achieving zero new cases of HIV infections.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"139-147"},"PeriodicalIF":4.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9663025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1007/s11904-023-00650-4
Holly L Peay, Stuart Rennie, Gail E Henderson
Purpose of review: There are growing expectations for the return of individual-level research results (RoR), which promotes autonomy and potential clinical and personal benefits. There are ethical and practical challenges, however, that may be exacerbated in research that assesses neurocognitive and psychological outcomes, including HIV-associated neurocognitive disorder (HAND). This paper reviews central concepts for RoR and recent empirical and conceptual articles from Alzheimer's disorder (AD) as a model for HIV.
Recent findings: Data from AD studies indicate high participant interest and low risk of harm from RoR, though additional research is needed. Investigators report a range of benefits, potential risks, and feasibility concerns. Standardized, evidence-based approaches are needed for RoR. For HIV research, we recommend a default position of offering RoR for cognitive and psychological outcomes. Investigators should justify decisions not to return results after assessing the potential value and feasibility of RoR. Longitudinal research is needed for feasible and evidence-based best practices.
{"title":"Reporting Individual-Level Research Results from Neurocognitive and Psychological Research in People Living with HIV: Lessons from Dementia Research.","authors":"Holly L Peay, Stuart Rennie, Gail E Henderson","doi":"10.1007/s11904-023-00650-4","DOIUrl":"https://doi.org/10.1007/s11904-023-00650-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>There are growing expectations for the return of individual-level research results (RoR), which promotes autonomy and potential clinical and personal benefits. There are ethical and practical challenges, however, that may be exacerbated in research that assesses neurocognitive and psychological outcomes, including HIV-associated neurocognitive disorder (HAND). This paper reviews central concepts for RoR and recent empirical and conceptual articles from Alzheimer's disorder (AD) as a model for HIV.</p><p><strong>Recent findings: </strong>Data from AD studies indicate high participant interest and low risk of harm from RoR, though additional research is needed. Investigators report a range of benefits, potential risks, and feasibility concerns. Standardized, evidence-based approaches are needed for RoR. For HIV research, we recommend a default position of offering RoR for cognitive and psychological outcomes. Investigators should justify decisions not to return results after assessing the potential value and feasibility of RoR. Longitudinal research is needed for feasible and evidence-based best practices.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"131-138"},"PeriodicalIF":4.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9669333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01Epub Date: 2023-04-04DOI: 10.1007/s11904-023-00656-y
Arjee Restar, Brian J Minalga, Ma Irene Quilantang, Tyler Adamson, Emerson Dusic, Leigh-Ann van der Merwe, Greg Millet, Danvic Rosadiño, Tanya Laguing, Elle Lett, Avery Everhart, Gregory Phillips, Rena Janamnuaysook, Pich Seekaew, Kellan Baker, Florence Ashley, Jeffrey Wickersham, Stephaun E Wallace, Don Operario, Kristi E Gamarel
Purpose of review: Pre-exposure prophylaxis (PrEP) represents one of the most effective methods of prevention for HIV, but remains inequitable, leaving many transgender and nonbinary (trans) individuals unable to benefit from this resource. Deploying community-engaged PrEP implementation strategies for trans populations will be crucial for ending the HIV epidemic.
Recent findings: While most PrEP studies have progressed in addressing pertinent research questions about gender-affirming care and PrEP at the biomedical and clinical levels, research on how to best implement gender-affirming PrEP systems at the social, community, and structural levels remains outstanding. The science of community-engaged implementation to build gender-affirming PrEP systems must be more fully developed. Most published PrEP studies with trans people report on outcomes rather than processes, leaving out important lessons learned about how to design, integrate, and implement PrEP in tandem with gender-affirming care. The expertise of trans scientists, stakeholders, and trans-led community organizations is essential to building gender-affirming PrEP systems.
{"title":"Mapping Community-Engaged Implementation Strategies with Transgender Scientists, Stakeholders, and Trans-Led Community Organizations.","authors":"Arjee Restar, Brian J Minalga, Ma Irene Quilantang, Tyler Adamson, Emerson Dusic, Leigh-Ann van der Merwe, Greg Millet, Danvic Rosadiño, Tanya Laguing, Elle Lett, Avery Everhart, Gregory Phillips, Rena Janamnuaysook, Pich Seekaew, Kellan Baker, Florence Ashley, Jeffrey Wickersham, Stephaun E Wallace, Don Operario, Kristi E Gamarel","doi":"10.1007/s11904-023-00656-y","DOIUrl":"10.1007/s11904-023-00656-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pre-exposure prophylaxis (PrEP) represents one of the most effective methods of prevention for HIV, but remains inequitable, leaving many transgender and nonbinary (trans) individuals unable to benefit from this resource. Deploying community-engaged PrEP implementation strategies for trans populations will be crucial for ending the HIV epidemic.</p><p><strong>Recent findings: </strong>While most PrEP studies have progressed in addressing pertinent research questions about gender-affirming care and PrEP at the biomedical and clinical levels, research on how to best implement gender-affirming PrEP systems at the social, community, and structural levels remains outstanding. The science of community-engaged implementation to build gender-affirming PrEP systems must be more fully developed. Most published PrEP studies with trans people report on outcomes rather than processes, leaving out important lessons learned about how to design, integrate, and implement PrEP in tandem with gender-affirming care. The expertise of trans scientists, stakeholders, and trans-led community organizations is essential to building gender-affirming PrEP systems.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 3","pages":"160-169"},"PeriodicalIF":3.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1007/s11904-023-00646-0
Sara Svensson Akusjärvi, Ujjwal Neogi
Purpose of review: In the absence of a prophylactic/therapeutic vaccine or cure, the most amazing achievement in the battle against HIV was the discovery of effective, well-tolerated combination antiretroviral therapy (cART). The primary research question remains whether PLWH on prolonged successful therapy has accelerated, premature, or accentuated biological aging. In this review, we discuss the current understanding of the immunometabolic profile in PLWH, potentially associated with biological aging, and a better understanding of the mechanisms and temporal dynamics of biological aging in PLWH.
Recent findings: Biological aging, defined by the epigenetic alterations analyzed by the DNA methylation pattern, has been reported in PLWH with cART that points towards epigenetic age acceleration. The hastened development of specific clinical geriatric syndromes like cardiovascular diseases, metabolic syndrome, cancers, liver diseases, neurocognitive diseases, persistent low-grade inflammation, and a shift toward glutamate metabolism in PLWH may potentiate a metabolic profile at-risk for accelerated aging.
{"title":"Biological Aging in People Living with HIV on Successful Antiretroviral Therapy: Do They Age Faster?","authors":"Sara Svensson Akusjärvi, Ujjwal Neogi","doi":"10.1007/s11904-023-00646-0","DOIUrl":"https://doi.org/10.1007/s11904-023-00646-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>In the absence of a prophylactic/therapeutic vaccine or cure, the most amazing achievement in the battle against HIV was the discovery of effective, well-tolerated combination antiretroviral therapy (cART). The primary research question remains whether PLWH on prolonged successful therapy has accelerated, premature, or accentuated biological aging. In this review, we discuss the current understanding of the immunometabolic profile in PLWH, potentially associated with biological aging, and a better understanding of the mechanisms and temporal dynamics of biological aging in PLWH.</p><p><strong>Recent findings: </strong>Biological aging, defined by the epigenetic alterations analyzed by the DNA methylation pattern, has been reported in PLWH with cART that points towards epigenetic age acceleration. The hastened development of specific clinical geriatric syndromes like cardiovascular diseases, metabolic syndrome, cancers, liver diseases, neurocognitive diseases, persistent low-grade inflammation, and a shift toward glutamate metabolism in PLWH may potentiate a metabolic profile at-risk for accelerated aging.</p>","PeriodicalId":10930,"journal":{"name":"Current HIV/AIDS Reports","volume":"20 2","pages":"42-50"},"PeriodicalIF":4.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9426754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}